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Background: The prevalence of type 2 diabetes is increasing in youths and differs from adult-onset type 2 diabetes in its characteristics and progression. Currently, only two drugs are approved for youth-onset type 2 diabetes and many patients are not meeting glycemic targets. Clearly, there is an urgent need to complete clinical trials in youths with type 2 diabetes to increase the therapeutic choice for these patients. However, factors such as limited patient numbers, unwillingness of patients to participate in trials, failure to meet strict inclusion and exclusion criteria, and poor clinic attendance have limited the size and number of trials in this complicated patient demographic. Recommendations: This is a narrative opinion piece on the design of clinical trials in youth-onset type 2 diabetes prepared by researchers who undertake this type of study in different countries. The review addresses possible ways to enhance trial designs in youth-onset type 2 diabetes to meet regulatory requirements, while minimizing the barriers to patients' participation. The definition of adolescence, recruitment of sufficient patient numbers, increasing flexibility in selection criteria, improving convenience of trial visits, requirements of a control group, possible endpoints, and trial compliance are all considered. The authors recommend allowing extrapolation from adult data, using multiple interventional arms within future trials, broadening inclusion criteria, and focusing on endpoints beyond glucose control, among others, in order to improve the successful completion of more trials in this population. Conclusions: Improvements in trial design will enable better recruitment and retention and thereby more evidence for treatment outcomes for youth-onset type 2 diabetes. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Oral is the property of Benemerita Universidad Autonoma de Puebla and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Scientific information is available on the relationship between diet, physical activity and chronic-degenerative diseases. To prevent overweight and obesity in childhood, coordinated interventions including private and government sectors are required in an ecological context. It is necessary to transform obesogenic environments where children live, as well as to change their dietary habits and physical activity. At present, in many families the intake of simple sugars and saturated lipids is high, whereas fruits and vegetables are much less included in the diet. On the other hand, sedentarism and obesity have become a civilization symbol for society, and very few are aware of obesity risks and consequences on human health. The ENSANUT 2006, a national survey on nutrition and health, it is proposed as a tool to design public health policies to prevent obesity by modifying, when possible, community environment, and by transforming the unhealthy atmosphere of school into a healthy one. Healthful tile styles must be taught and inherited from parents to their children. No country has under control this epidemic; however, there is a good expectative from experiences of countries such as Germany, Great Britain, Spain and Chile. The importance to put into practice the guidance system for healthy beverage consumption, especially in schools, and to regulate food and beverage advertising in mass media is highlighted for Mexico. The WHO global strategy on diet, physical activity and health is suggested as the guide to be adopted by the Mexican Health Ministry to perform important changes in dietary and physical activity, and to include all social actors to prevent overweight and obesity. [ABSTRACT FROM AUTHOR]

Background: With the recent increased awareness of youth-onset type 2 diabetes (T2D) cases, an overview of national differences in epidemiology data is needed to obtain a global picture of the disease development. Methods and Aim: This review examined national epidemiology data of youth-onset T2D published between 1st January 2008 and 15th January 2018, and searched for national guidelines on this topic to understand better national similarities and differences. Results: Of the 1005 articles and 14 congress abstracts identified, 42 studies were included. The highest reported prevalence rates of youth-onset T2D were found in the U.S. and China (38 and 18 cases/100,000 people, respectively), and lowest in Denmark and Ireland (0.6 and 1.2 cases/100,000 people, respectively) (Figure). However, the highest incidence rates were reported in Taiwan and the UK (63 and 33 cases/100,000 people, respectively), with the lowest in Fiji and Austria (0.4 and 0.6 cases/100,000 people, respectively) (Figure). These differences may be partly explained by variations in diagnostic criteria, national screening recommendations, and ethnicity within countries. Conclusions: Our review suggests that published national epidemiology data for youth-onset T2D may underestimate its disease burden. Finding optimal diagnostic criteria and screening strategies for this disease should be of high interest to every country. Disclosure: J.L. Lynch: Board Member; Self; American Academy of Pediatrics. Consultant; Self; Novo Nordisk Inc. Research Support; Self; Daiichi Sankyo Company, Limited, National Institutes of Health, Novo Nordisk Inc., Pediatric Diabetes Consortium. M. Barrientos-Pérez: Advisory Panel; Self; Novo Nordisk A/S. Research Support; Self; Eli Lilly and Company, Novo Nordisk A/S, Sanofi. Speaker's Bureau; Self; Pfizer Inc. M. Hafez: Advisory Panel; Self; Merck & Co., Inc. Consultant; Self; Global Expert Panel for T2 diabetes. M. Jalaludin: Advisory Panel; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S. Research Support; Self; Merck Sharp & Dohme Corp., Novo Nordisk A/S. M. Kovarenko: Advisory Panel; Self; Novo Nordisk Pediatric Type 2 Diabetes Global Expert Panel. Speaker's Bureau; Self; Berlin-Chemie AG, LifeScan, Inc., Medtronic, Novo Nordisk A/S, Sanofi. V. Paturi: Advisory Panel; Self; Novo Nordisk Foundation. Board Member; Spouse/Partner; DiabetOmics Inc., DiabetOmics Inc. Board Member; Self; DiabetOmics Medical. Consultant; Self; Ramdevrao Hospital. Employee; Self; DiabetOmics Medical. Research Support; Self; Eli Lilly and Company, Hetero Pharma, Ipca Laboratories Ltd., IQVIA, Novo Nordisk A/S, Quintiles, RSSDI (Research Society for the Study of Diabetes in India), Sanofi. Speaker's Bureau; Self; Novo Nordisk A/S. Stock/Shareholder; Self; DiabetOmics Inc. D. Weghuber: Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Johnson & Johnson. Funding: Novo Nordisk A/S [ABSTRACT FROM AUTHOR]

Background: Obesity during childhood is a risk factor for developing cardiovascular diseases during adulthood., Aim: To measure insulin and glucose levels and parameters of insulin resistance in obese, overweight and normal weight Mexican children., Material and Methods: Comparative study of 21 obese children with a body mass index (BMI) over percentile 95, aged 10 ± 1 years (10 males), 14 children aged 10 ± 2 (7 males) with a BMI between percentiles 85 and 94 and 16 children aged 9 ± 2 years (3 males) with a body mass index between percentiles 10 and 84. Body weight, blood pressure and waist circumference were measured and a blood sample was obtained to measure fasting glucose and insulin levels. Homeostasis model of insulin resistance (HOMA) and quantitative insulin sensitivity check index (QUICKI) were calculated., Results: Among obese, overweight and normal weight children, insulin levels were 14.9 (95% CI 10.90-18.99), 7.20 (CI 5.12-9.28) and 4.73 (CI 95% 1.92-7.53) uU/ml, respectively. The figures for HOMA were 3.16 (95% CI 2.20-4.12), 1.49 (95% CI 1.03-1.94) and 0.97 (95% CI 0.35-1.60), respectively. The figures for QUICKI were 0.331 (95% CI 0.319-0.343), 0.371 (95% CI 0.349-0.393) and 0.419 (95% CI 0.391-0.446), respectively. Compared to their normal weight counterparts, the risk of obese children and those with a waist circumference over percentile 90 of having a HOMA over 3.16 was 17 and 10 times higher, respectively. BMI correlated better than waist circumference with insulin levels., Conclusions: Obese children have higher levels of insulin resistance than their normal weight counterparts.